Sleep Effort and Insomnia Severity: The Role of Bedtime Procrastination

Background and Objective We aimed to investigate the mediating role of bedtime procrastination in the relationship between sleep effort and insomnia severity in this study. Methods We included 497 university students in this study. All the participants completed the sociodemographic data form, Glasgow Sleep Effort Scale (GSES), Insomnia Severity Index (ISI), Depression-Anxiety-Stress Scale-21 (DASS-21), and Bedtime Procrastination Scale (BPS). We divided the participants into groups, according to their GSES and BPS scores, those with high-low sleep effort and those with BP (+) and BP (-), respectively. We compared the variables in these groups. Finally, we analyzed the mediating role of bedtime procrastination in the relationship between sleep effort and insomnia severity. Results The mean age of the participants was 20.41 ± 1.83 years. ISI, BPS, and DASS-21 were statistically significant in the group with high sleep effort (p < 0.01). Among the psychometric instrument scores, the highest correlation with GSES was with ISI, and then there was a statistically significant positive correlation with DASS-21. In addition, there was a statistically significant positive correlation between GSES and BPS. Bedtime procrastination played a partial mediation role in the relationship between sleep effort and insomnia severity. Conclusions Bedtime procrastination partially mediated the relationship between sleep effort and insomnia severity. Therapists should consider sleep effort and bedtime procrastination on their agenda in cognitive behavioral therapy sessions for insomnia

Adaptation and Validation of the Turkish Version of the Ford Insomnia Response to Stress Test in University Students

OBJECTIVE: We adapted the Ford Insomnia Response to Stress Test to Turkish (FIRST-T) and validated it. METHODS: We randomly divided 774 Turkish university students into two equal groups for exploratory (EFA) and confirmatory factor analysis (CFA). McDonald\u27s omega and Cronbach\u27s alpha values were utilized for reliability analyses. Item response theory (IRT) approach also used for psychometric properties on the full sample. For discriminant validity, study sample were classified into high and low sleep reactivity groups, and their sociodemographic and sleep data were compared. RESULTS: EFA results suggested a one-factor structure of the FIRST-T, which was confirmed by CFA results. The FIRST-T had solid internal reliability. Item analysis results showed that all the items could distinguish between low and high scorers. This scale showed the same construct (clinical insomnia vs good sleepers) across the sexes in multi-group CFA and differential item functioning results. In the high FIRST-T score group, sleep quality, severity of insomnia, and anxiety scores were higher. In this group, more participants had clinical insomnia according to the Insomnia Severity Index (ISI) and were poor sleepers according to the Pittsburg Sleep Quality Index (PSQI) (p \u3c 0.01). CONCLUSION: The FIRST-T has robust psychometric properties that assesses sleep reactivity among university students

Does Viral Anxiety Influence the Insomnia Severity Among Patients With Insomnia Disorder During COVID-19 Pandemic?

Background and Objective We aimed to investigate whether viral anxiety affects insomnia severity in patients with insomnia disorder during the coronavirus disease 2019 (COVID-19) pandemic. In addition, we examined whether viral anxiety mediates the influence of dysfunctional beliefs about sleep on insomnia severity. Methods The medical records of 111 patients who visit the sleep clinic from September 2021 to May 2022 were reviewed. Patients’ symptoms were rated with rating scales including Insomnia Severity Index (ISI), Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Dysfunctional Beliefs and Attitudes about Sleep-16 items (DBAS-16), Patient Health Questionnaire-9 items (PHQ-9), Epworth Sleepiness Scale, and discrepancy between desired time in bed and desired total sleep time (the DBST index). Results The SAVE-6 score was not significantly correlated with ISI score among insomnia patients. Linear regression analysis showed that the ISI score was expected by PHQ-9 (β = 0.21, p = 0.038) and DBAS-16 (β = 0.42, p < 0.001). Mediation analysis showed that viral anxiety did not mediate the influence of dysfunctional beliefs about sleep on insomnia severity. Conclusions We could not observe the mediating effect of viral anxiety on the association between dysfunctional beliefs about sleep on insomnia severity. Though COVID-somnia was one of big issues in this COVID-19 pandemic, the influence of virus on the severity of insomnia among insomnia patients needs to be interpreted cautiously

Type D personality to insomnia: Sleep reactivity, sleep effort, and sleep hygiene as mediators

BACKGROUND: Insomniacs are heterogenous group with very diverse personalities. We aimed to investigate the mediating role of sleep reactivity (SR), sleep hygiene (SH), and sleep effort (SE) in the relationship between Type D personality and insomnia. MATERIALS AND METHODS: We conducted a cross-sectional survey among 474 participants. The survey comprised the sociodemographic data form, Insomnia Severity Index (ISI), D Type Personality Scale (DS-14), Ford Insomnia Response to Stress Test (FIRST), Glasgow Sleep Effort Scale (GSES), and Sleep Hygiene Index (SHI). We conducted hierarchical multiple regression analysis to identify the associations between age, sex, SR, Type D personality traits, SE, SH, and insomnia severity. We subsequently conducted mediation analyses to examine whether SR, SH, and SE mediated the relationship between Type D personality and insomnia. RESULTS: ISI, DS-14, FIRST, SHI, and GSES scores were significantly higher in individuals with Type D personality. Female sex, SR, Type D personality traits, SE, and SH explained 45% of the variance in insomnia severity. When age, sex, insomnia response to stress, and Type D personality traits were controlled, SE and SH significantly explained 25% of the variance in insomnia severity (R (2) = 0.45, R (2) change = 0.25, F (6.474) = 65.58, p \u3c 0.001). SR, SE, and SH each played a partial mediating role between Type D personality and insomnia. CONCLUSION: The findings showed that individuals with Type D personality had high SR and that individuals with a higher number of these personality traits exhibited more severe insomnia symptoms through high SR, greater SE, and worse SH

Serum NOX1 and Raftlin as new potential biomarkers of Major Depressive Disorder: A study in treatment-naive first episode patients

Introduction: Biological factors are known to be important in understanding the pathogenesis of Major Depressive Disorder (MDD). Oxidative stress and neuroinflammation pathways are likely to play a critical role here. Methods: We undertook a study to investigate two novel biomarkers - serum NADPH oxidase 1 (NOX1) and Raftlin levels - in treatment-naive, smoking-free first episode patients with MDD compared to healthy controls (HCs) matched for age, sex and body mass index. Results: We found increased NOX1 and Raftlin levels in MDD patients compared to HCs. Both parameters showed very good diagnostic performance in the MDD group. In addition, we found a significant positive correlation between depression severity (HAM–D) scores and both biomarker levels in the patient group. Conclusion: To the best of our knowledge, this is the first human study to evaluate serum NOX1 and Raftlin levels in depression. NOX1, an important source of reactive oxygen species (ROS), and Raftlin, which may play a role in the inflammatory process, represent novel potential biomarkers of MDD. These findings support the implication of oxidative stress and inflammatory processes in patients with MDD, and indicate that the deteriorated ROS-antioxidant balance can be regulated via NOX1 in patients with depression.Kemal Akalp ; Serkan Cagla